Idiopathic sideroblastic anemia: presence of sideroblastic changes in the erythropoietic precursors cultured from peripheral blood.

Peripheral blood mononuclear cells from five patients with idiopathic sideroblastic anemia were examined in clonal culture for circulating erythropoietic precursors. Three of these patients had relatively mild anemia and revealed significant burst formation. Two patients who had severe anemia and required regular blood transfusions showed severe diminution or absence of circulating precursors. These results could suggest that the number of circulating erythropoietic precursors reflects effective erythropoiesis in the marrow. Ultrastructural morphology and ultrastructural Prussian-blue staining of the bursts from a patient revealed the characteristic mitochondrial deposition of ferrugionous material in pathologic normoblasts. Peripheral blood clonal cell cultures would, therefore, appear to be a potentially useful tool for analysis of biochemical abnormalities in idiopathic sideroblastic anemia.